Multilevel Hemilaminectomy Economical for Lumbar Stenosis

Mean two-year cost per quality-adjusted life year $33,700 following surgery

FRIDAY, Sept. 23 (HealthDay News) -- Multilevel hemilaminectomy is a cost-effective treatment for lumbar stenosis-associated radiculopathy, and it improves pain, disability, and quality of life among patients, according to a study published in the August issue of The Spine Journal.

Scott L. Parker, M.D., from the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues investigated the comprehensive medical and societal costs of multilevel hemilaminectomy, and its cost-effectiveness in 54 patients with lumbar stenosis-associated radiculopathy who underwent at least six months of failed conservative therapy. Data were collected through an outcomes questionnaire over a two-year period, incorporating total back-related medical resource utilization, missed work, and improvement in leg pain (visual analog scale for leg pain [VAS-LP]), disability (Oswestry Disability Index [ODI]), quality of life (Short Form-12 [SF-12]), and health state values (quality-adjusted life years [QALYs]). The two-year direct cost of medical resource use, indirect cost of patient and caregiver workday losses, and mean total two-year cost per QALY gained post surgery were calculated.

The investigators found a significant improvement in the two-year VAS-LP, ODI, and SF-12 compared to preoperative levels, and the mean gain over the two-year interval was 0.72 QALYs. The mean total two-year cost of multilevel hemilaminectomy was $24,264, including $10,220 surgery cost, $3,592 outpatient resource utilization cost, and $10,452 indirect cost. There was a mean two-year cost per QALY gain of $33,700 linked to the surgery.

"Multilevel hemilaminectomy is a cost-effective treatment of lumbar radiculopathy," the authors write.

Two authors disclosed financial relationships with the medical device industry.